Practical Nursing (PN) Program Handbook
Last updated: July 2019
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1.1 Chair's Message
We, the faculty and staff of the Continuing Care department welcome you! By choosing one of our programs you are demonstrating that you care about your community and that you have an interest and commitment to working with people. During the course of your studies we will partner with you to strengthen your knowledge, skills and values in preparation for your chosen career.
We hope you'll take the time to review the information in this handbook, as well as the Health & Human Services Student Handbook. They contain Camosun College policies and procedures, student resources and other important information to assist and guide you in making your educational experience a success. Get to know the campus, your instructors and your fellow students – they will all be part of your support team.
We are delighted that you have chosen the Practical Nursing program as your area of study and will take great pleasure in getting to know you, while we work and learn together. We hope you enjoy your experience with us, and wish you success in all that you do!
All instructors have office hours. In addition they can be reached by email or telephone. The telephone voice messaging system is operational 24 hours a day. The instructor will return your call or correspondence as soon as possible.
If you have any questions or concerns, please approach the Program Leader or one of your instructors directly. You can also stop by the 2nd floor reception area where someone will be happy to assist you.
Chair, Continuing Care Department
2.1 Program Purpose
The provincial practical nursing program (PPNP) is designed to provide learners with the knowledge, skills, judgments, and attitudes to perform to the full range of competencies as identified by the College of Licensed Practical Nurses of British Columbia. The curriculum provides a learning experience that is integrated, professional, collaborative, and culturally sensitive with an aim to prepare graduates to care for individuals (and by extension, families of individuals) at multiple life stages and in a variety of practice settings.
Consistent with the British Columbia College of Nursing Professionals (BCCNP), and the Canadian Council for Practical Nurse Regulators (CCPNR) Entry-to-Practice Competencies for Licensed Practical Nurses, the focus for beginner's practice is "care of clients with less complex and more predictable outcomes". Additionally, upon successful completion of the program, learners will possess the competencies to successfully complete the Canadian Practical Nurse Registration Exam (CPNRE).
With this curriculum, caring is viewed as a core concept. Practical Nurses foster client empowerment in care planning and decision making, and are cognisant of their unique biological, psychosocial, spiritual, cultural, and environmental complexity. Practical Nurses care for clients across the lifespan, providing safe, knowledgeable, and integrated care through critical thinking and clinical judgement.
The curriculum supports a deliberate, client focused approach and fosters the development of a conscious relationship with the client and the environment in which the learning takes place.
Learning occurs through formal and informal study, mentorship, coaching, role modeling and experience. Learning is lifelong, and is facilitated by a learner-owned approach that promotes cultural safety, caring, independence, critical inquiry,and creativity. The curriculum uses multiple approaches to encourage learning and embraces concept-based, case-based, skill-based, and integrated learning experiences. The curriculum builds on the learners' prior learning and life experience, and promotes collaborative learning through interdisciplinary understanding and effective team functioning.
3.2 Organizing Concepts
The curriculum organizing concepts provide a foundation for program learning outcomes. The organizing concepts also guide the development of curriculum concepts and required courses. In developing these concepts, the Curriculum Advisory Group continually reflected on the BCCNP competencies, consulted the CPNRE blueprint, and synthesized the available contextual data surrounding Practical Nurse education and practice. In addition, each member contributed their vision of the practical nursing graduate of the future and answered the question: do the proposed organizing concepts encapsulate important ideas that are essential for successful practice now and into the future? Based on this process, curriculum organizing concepts were developed as being: integrative, professional, knowledgeable, competent, and client focused.
Integrative: The Practical Nurse is integral in the assessment, planning, implementation, evaluation and documentation of nursing care. The Practical Nurse promotes, supports, and advocates for client self-determination to achieve optimum health outcomes. The foundation of practical nursing is defined by relevant law, scope of practice as defined by regulation set out in legislation, standards of practice, code of ethics, and entry-level competencies.
Professional: Practical Nurses practice collaboratively, respecting the shared and unique competencies of other members of the health-care team. A code of ethics provides direction for the Practical Nurse to uphold the highest standard of care as defined by the scope of practice. The Practical Nurse maintains autonomy within the legislated scope of practice and is legally accountable to the client, the employer, and the profession. The Practical Nurse demonstrates a self-reflective approach to practice and demonstrates leadership while fostering continued growth of self and others to meet the challenges of the evolving health-care system.
Knowledgeable: The Practical Nurse uses critical thinking to guide the formulation of clinical decisions, based on evidence-informed practice. Practical Nurses follow a systematic approach when applying the nursing process and deliver care while respecting diversity. Practical Nurses are knowledgeable about trends and issues that impact the client, the health-care system and team. Practical Nurses are active participants in health promotion, illness prevention, reduction of harm,and risk management activities.
Competent: Practical Nurses integrate knowledge, skills, behaviours, attitudes, critical thinking and clinical judgment expected of an entry-level Practical Nurse to provide safe, competent, and ethical care. Practical Nurses care for clients throughout the lifespan and are responsible for providing care while developing and maintaining a therapeutic nurse-client relationship. Practical Nurses perform holistic, comprehensive and specific nursing assessments to achieve mutually agreed upon health outcomes. Using evidence informed practice, Practical Nurses select and implement appropriate nursing interventions.
Client Focused: Practical Nurses assist clients to identify actual and potential health goals and outcomes, support clients to assume responsibility for their health, involve clients in developing and prioritizing their plan of care, and provide information and access to resources. Practical Nurses collaborate with clients and other health team members in discharge planning, planning and implementing strategies to enhance client learning, evaluating client learning and revise strategies as necessary. Practical Nurses provide care that affirms, respects, and fosters cultural expression by others.
4.1 Performance Indicators
The following program outcomes describe what learners are expected to achieve by the end of their educational program and describe key professional abilities, incorporate the curricular philosophical approach, and highlight the core concepts.
Upon completion of the Camosun College Practical Nursing Program, graduates will:
- Apply the Entry-to-Practice Competencies for Licensed Practical Nurses (2013) to provide safe, competent, culturally safe and ethical care.
- Practice within relevant legislation, scope of practice, standards of practice, and code of ethics as set out by the Health Professions Act and the BCCNP.
- Value and engage in continuous learning to maintain and enhance competence
- Practice in collaboration with other members of the health care team to meet the collective needs of their clients
- Participate in interprofessional problem solving and decision making processes
- Advocate for and facilitate change reflecting evidence-informed practice
- Make practice decisions that are client specific and consider client acuity, complexity, variability, and available resources
- Use critical thinking, clinical judgment and knowledge of assessment to plan, implement, and evaluate the agreed upon plan of care
- Develop a collaborative relationship with clients by connecting, sharing, and exploring with them in a caring environment
- Provide culturally safe, person-centred care across the lifespan that recognizes and respects the uniqueness of each individual and is sensitive to cultural safety and diversity
- Provide leadership, direction, assignment, and supervision of unregulated care providers as appropriate
- Identify one's own values, biases, and assumptions and the influence of these on interactions with clients and other members of the health care team
6.2 Appropriate Use of Electronic Devices/Mobile Devices
Cell phones are not permitted in the lab or classroom unless given prior approval by the instructor. Any emergency calls for students may be directed to the Health & Human Services administration office at 250-370-3161.
7.1 Expectations of Student Performance
A minimum of 65% ("C+") in each theory course, except PNUR 119 and PNUR 129 which require a minimum of 80% (A-) are prerequisites for progression into each clinical placement. Each clinical must be successfully completed and passed in order to progress to the next term, and following the fourth clinical, progress into Preceptorship. Preceptorship must be successfully passed to graduate from the program.
The School reserves the right to change or cancel any provision or requirement at any time.
Re-entry to the Program
The Practical Nursing program must be completed within 3 years of starting the program.
7.5 Dress Code and Guidelines
Clinical Dress Code
Clinical dress code applies during Integrated Lab Assessments.
The manner in which you care for and present yourself reflects your respect for the clients and staff with whom you work. It is important that you present a professional image of yourself as a caregiver and as a representative of the PN program.
Dress Code for Uniform, when in clinical
Camosun College PN uniform (a washable cardigan with ¾ length sleeves is permitted).
Dress Code for Non-Uniform, when in community practicums
Generally, the dress code for community practicums is casual professional attire. Please contact your site to ask about their dress code before you start.
Students coming to clinical/practicum with incomplete or unkempt uniforms may be refused admission to the clinical site.
The following dress code expectations apply to both uniform and non-uniform sites:
- White or black shoes with soft soles and rubber heels, closed toes, low heels and closed back (running shoes with solid uppers acceptable). For infection control purposes shoes are to be used exclusively for clinical placement. Clogs and sandals are not acceptable.
- Name tag
- Available for purchase through the Camosun Bookstore. Must be worn in all clinical/community settings unless students have received specific instructions otherwise. Name tag will have first name only on it.
- No jewellery is permitted in a clinical area, with the following possible exceptions: Medi-alert bracelets/necklaces single, plain wedding band small stud earrings, silver, gold, pearl
- Students MUST have a clip-on or pin-on watch with a second hand. Wrist watches are not allowed. The Island Health Hand Hygiene policy specifies that: "Wrist watches, bracelets, bangles or other wrist adornments must be removed when caring for patients (exception: Medical Alert Bracelets) as they inhibit correct hand hygiene".
- Clean, neat and kept up off collar and face. Long hair tied back or in a bun; no long ponytails. No hair extensions to be worn in practicum.
- Full beards are not permitted (due to mask fit requirements); moustaches/goatees must be trimmed short and must fit within a mask.
- Short, clean. No nail polish. No artificial nails or nail extensions.
- Minimal make-up
- Body Odour
- Unpleasant body odours from poor hygiene are unacceptable. Please remember to bathe and use deodorant.
- No perfume/cologne or aftershave to be worn in community, clinical or transition situations. Care facilities are perfume-free zones.
7.8 Clinic/Lab Information
The lab is for you to practice the skills you will be learning. During the program, you will have scheduled class times in the lab.
If you would like to book practice time during the week, "open lab practice" may be booked Monday to Friday, 8am-4pm with the Program Assistant if the lab is free. After 4pm or on the weekend, an instructor must be in the lab to supervise. Your instructor will book this lab time. Please adhere to the lab use guidelines posted in the lab.
8.1 Clinical and Community Placement Protocol
Diverse opportunities for student learning are essential in order to prepare them for the realities of the work place. Therefore, student placement occurs within a variety of Vancouver Island Health Authority facilities and agencies which offer a range of learning opportunities. Additionally, student learning is facilitated through clinical experiences with a variety of instructors. Teacher recommendations and student requests related to placement are considered in relation to student learning needs and opportunities for success.
8.2 Student Safety and Orientations on Practicums
Behaviour endangering the client
Because the people that our students look after are in a vulnerable position, we MUST be absolutely sure that their safety is secure. Consequently, when a student in the clinical setting puts the client in physical or emotional jeopardy, this will be considered a very serious matter.
Physical Jeopardy: any action or inaction on the part of the student which threatens the client's physical well-being. Such behaviours may include those which endanger the physical safety of the client, such as interference with essential care, failure to carry out required care, failure to behave in a responsible or accountable manner.
Emotional Jeopardy: any action or inaction on the part of the student which threatens the client's emotional well-being. Such behaviours may include interpersonal communications which belittle or demean the client or practices which blatantly defile the dignity of the client.
Any time a safety error occurs during the clinical experience, the student involved will be asked to fill out a Conference Form. If the safety error results in injury to the student or others, then a facility incident report must also be completed. Copies of all incident reports are placed on the student's file.
In situations where a student is displaying behaviour which places the client in physical or emotional jeopardy, the instructor will follow the Continuing Care Policy on Documentation of Concerns. The student will be clearly informed of the behaviour required for continuance in the clinical experience. If behaviour continues that places the client in physical or emotional jeopardy, the student can be required to leave the clinical site.
NOTE: Students who are found to be unsafe to self or others, or demonstrate unethical, unprofessional behaviour in the clinical area may be asked to leave the setting for the remainder of that day. The student, the program instructors and the Chair will subsequently meet to discuss the student's performance and develop a recommendation for remediation.
Examples of unsafe, unethical and unprofessional practice include, but are not limited to:
- arriving at the clinical site setting smelling of alcohol and/or behaving as though intoxicated and/or incapacitated by consumption of prescription or elicit drugs
- stealing from clients/staff
- destroying, defacing or otherwise knowingly damaging property
- assaulting or threatening to assault another person
- harassing other students, faculty members, facility/agency staff members or clients
- illness which interferes with the assumption of responsibilities
- not knowing own limits and not seeking help appropriately
- inadequate preparation for patient care
- not reporting significant client information to appropriate health care professional (e.g. nurse)
- inappropriate behaviour toward clients, peers, staff or instructor (i.e. swearing, foul or course language)
- implementing unsafe care
Serious disregard of program policies includes such things as:
- not implementing standard safety principles in performance of lifts and transfers consequently endangering client safety
- operating a mechanical lift without supervision
- feeding a client who is at risk of choking in the client's room without supervision
If the student is temporarily removed from the clinical area, the instructor must inform the Dean or designate who may consult with the appropriate Chair regarding the conditions for return to the clinical assignment. The student will be advised of these conditions in writing. The student can appeal this action through the Student Appeal Procedure.
When specific prescriptive strategies have been implemented without significant change in the student's performance, and the student is demonstrating unsafe practice, a Compulsory Withdrawal by the Dean will be invoked, see policy E1.5. If appropriate, conditions for re-entry to the program will be communicated to the student in writing.
8.3 Practice Guidelines/Professional Standards of Practice
Students must attend all clinical/preceptorship experiences. In the event of illness or other unavoidable cause of absence, the student must notify the agency prior to the time she/he is expected. The student is expected to leave a message and phone number at the college or clinical agency for the instructor. In the event a student is absent from clinical/preceptorship, the situation will be evaluated by the instructors on an individual basis, taking into consideration the amount of time missed, reason for absence and the student's ability to meet learning goals and evaluations.
During clinical/preceptorship there are a minimum number of hours that must be completed. If a student fails to meet this requirement, he/she may have the opportunity to make up the required hours pending the instructor's ability to arrange further clinical time and potentially with additional cost to the student; OR the student may be required to withdraw from the program and re-enter the following year to complete. Absences will be recorded on the final evaluation form and will become part of the student's file. Physicians' notes will be required for absences from clinical/preceptorship due to illness.
Guidelines for Practice
Please Note: All PN students must read and understand practice guidelines prior to commencing each clinical situation. Any questions for clarification may be directed to the clinical instructors.
- PN students are considered supernumerary on any unit to which they are assigned. They will not take the place of paid personnel.
- Students may perform all procedures independently after they have been determined competent to do so by the instructor. Approval will be given to students either verbally or in writing.
- Students may use mechanical tubs without supervision after the instructor has been satisfied that they are competent and safe. There must always be two people present when using mechanical devices even after the student has been deemed competent.
- When using mechanical devices and mechanical transfer devices, students must be supervised by regular staff or an instructor until the student has been certified competent and safe. There must always be two people present when using mechanical devices even after the student has been certified competent. The second person may be another student who has also been deemed competent by the instructor.
- Students must always notify the instructor of any safety incidents that occur in the clinical setting.
- Students may perform one person transfers without supervision once the instructor is satisfied with the students' competencies in this skill. A two person transfer may be performed by two students who have demonstrated their competency of this skill to their instructor.
- Students will respect a client's right to confidentiality at all times.
- Students will wear their student identification when doing home visits or agency visits.
- Students may not witness consents or any other legal documents.
- If a student is going to be late or absent from a clinical shift, they must phone the clinical site prior to the shift starting. They must also leave their name and a contact number where the instructor can call them.
- If an instructor does not arrive at the clinical site for any reason, students must depart from the site immediately. After leaving the site, students should phone the instructor for further direction. Students must not be at any site without an instructor present.
8.4 Practice Appraisals
Evaluation of Learning
Principles of Giving Feedback
These principles apply whether an instructor is giving feedback to a student or the student is giving feedback to the instructor or to a peer:
- Give feedback in a timely manner, i.e. when you note excellence or as soon as issues/concerns arise.
- Describe what you observed in a clear, direct and specific manner
- Avoid labelling behaviours.
- Explore the meaning the behaviour has for each of you.
- Clearly define expected performance standards.
- Identify strategies to assist in meeting the standards. Where improvement is needed establish time lines for achieving expected outcomes.
- Outline prescriptive strategies that may assist learning.
- Clearly state consequences of not meeting expected outcomes in time.
Documentation of Concerns
In situations where issues or concerns arise and students are not meeting expected outcomes, written documentation will summarize the situation. Student Progress Notes and Conference Forms (see Appendix 2) will be used. These documents will be signed by both parties.